Senior Healthcare Data Analyst (AI)

Location: Remote - US; must work from within the United States

Salary: $140,000–$170,000 base salary per year, plus equity

Company

hirify.global provides an AI-powered healthcare intelligence platform that helps health plans improve claims auditing, payment integrity, transparency, and financial outcomes.

What you will do

• Design transformations that convert raw professional and institutional claims, including 837 EDI, UB-04, and CMS-1500 data, into canonical models.
• Apply ICD-10-CM/PCS, CPT, and HCPCS coding standards throughout claims processing.
• Audit data quality, troubleshoot pipeline issues, and validate outputs end to end with SQL and Spark SQL.
• Identify overpayment patterns, coordination-of-benefits issues, billing edits, and payment integrity opportunities.
• Drive AI-assisted analysis and pipeline development by iterating with LLMs and identifying manual processes for automation.
• Support client data-feed onboarding and partner with data engineers, data scientists, clinical staff, and product managers.

Requirements

• 5+ years of direct experience with healthcare claims data, including 837 EDI, encounter data, or medical billing.
• Deep knowledge of professional and institutional claims, ICD-10-CM/PCS, CPT, HCPCS, UB-04, and CMS-1500.
• Hands-on experience with payment integrity, overpayment detection, coordination of benefits, billing edits, or claims-editing logic.
• Advanced SQL skills and practical knowledge of data modeling for analytics.
• Familiarity with CMS regulations, commercial payer guidelines, and claims adjudication.
• Bachelor’s degree in business, computer science, health informatics, or a related field.

Nice to have

• Knowledge of MS-DRG/APR-DRG pricing, fee schedules, per diem, or capitation.
• Proficiency with Spark SQL or a comparable distributed query engine.
• Experience with ETL/ELT pipeline development or collaboration with data engineers on pipeline design.
• Exposure to value-based care or risk adjustment, including HCC coding and RADV.

Culture & Benefits

• Digital-first, remote work environment within the US.
• Flexible and trusting working environment with strong employee ownership.
• Medical, dental, and vision coverage for employees and families.
• Unlimited flexible time off.
• 401(k) with employer match, equity, and additional benefits.